This is a general guideline of what will occur at visits during a routine, uncomplicated pregnancy. If you are high risk or having problems you will be seen more often. If you believe there is something occurring in your pregnancy that may be different, always ask!
First Prenatal Visit
This is normally about 8 to 10 weeks from your last menstrual cycle. It will probably be the longest visit during your pregnancy.
- Complete history and physical including Pap smear and genital cultures.
- Ultrasound (transvaginal). This will confirm your due date, allow us to see your baby’s heart rate and look for twins.
- Labs: Complete blood count, blood type and Rh factor, antibody screen, syphilis test, rubella, toxoplasmosis, varicella, thyroid, hepatitis screen, HIV, Cystic Fibrosis and urine culture. Additional labs will be drawn if your family is of Ashkenazi descent.
- Discussion of prenatal care and questions.
- Financial/insurance information needs to be completed and provided to the office.
Weeks 9-13
Referral for first trimester nuchal fold and referral for genetic testing as indicated. If it is too soon to hear a fetal heart, we will confirm it with a limited ultrasound. You should call your insurance company to confirm obstetrical coverage. We will take care of precertification and verification of benefits.
Weeks 13-20
You will be seen monthly for fetal heart tones, weight, blood pressure, urine sample and questions that may arise. There will be a follow up blood test to complete your first trimester screen.
Week 20
Full ultrasound to assess fetal anatomy. This is a good time to register for childbirth classes
Week 24
xThis will be a brief visit. We will do weight, BP, urine and listen to the baby’s heart. If you have not registered for prenatal classes this is a good time to do so.
Week 28
We will do your one-hour glucola test at this visit. This is a screen for gestational diabetes. We will also check your blood count, repeat the syphilis screen (required by the state of MD) and do an antibody screen and Rhogam if you are Rh negative. Your OB deposit or insurance balance is due at this time.
Week 30
Begin every 2-week visits. This will be another short visit. Are you interested in cord blood banking? You should arrange your tour of Shady Grove Hospital.
Week 32
This will be similar to the 30-week visit. You may be starting to think about actually having a baby and there may be more questions. Have you chosen your pediatrician?
Week 34
We will do another ultrasound to look at the baby’s size, amniotic fluid and placenta to be sure everything is on track. Be sure to pre-register for the hospital. Have you decided whose insurance the baby will be on after birth? Speak to your HR department at work to confirm insurance for the new member of your family.
Week 36
There will be a pelvic exam and cultures for Beta Strep. We will recommend that you have Tdap; a vaccine for tetanus and whooping cough. You will need to know if you have had a tetanus shot in the last 2 years. See the CDC’s guidelines on vaccinating pregnant women.
Weeks 37-40
Visits are now every week. There will be a pelvic exam at some of these visits, especially if you are having some contractions. Let us know if you are leaking fluid or having regular contractions. If you have special concerns about your delivery be sure to let us know. Please note, we do not do elective inductions before 39 weeks as it is dangerous for your baby’s health.
Week 40
This will be a longer visit. We will do a nonstress test where your baby’s heart rate is monitored. You may also have another ultrasound to check fluid and placenta. We will discuss timing and indications for induction.
Week 41
We should have a delivery plan set up now and are just seeing you one last time for a non-stress test, cervix check and questions.